Circumcision not cure-all for public health, ACON warns
ACON has reiterated its position to not support the implementation of male circumcision as a HIV prevention strategy in Australia, after a call last week by a number of local experts for public hospitals to perform infant circumcisions.
The calls came on the back of a new study which found that the procedure reduces risk of urinary infections, cancer and other conditions such as HIV following a comprehensive assessment of international evidence and a risk-benefit analysis of circumcision.
The study’s research leader, Brian Morris, a professor of Medicine at the University of Sydney, said the study shows that in uncircumcised infants, the risk of urinary tract infection and kidney inflammation is 10 times higher than for circumcised boys.
The study also suggests that in later life, the risk of HIV and syphilis is three to eight times higher, while the chances of developing prostate cancer and penile cancer are also increased for uncircumcised males.
“The evidence in favour of infant circumcision is now so strong that advocating this … procedure for baby boys is about as effective and safe as childhood vaccination,” Morris said.
“The scientific evidence shows no adverse effects on sexual function, sensitivity, satisfaction or sensation, if anything the opposite.
“It is now up to state governments to ensure that bans on elective infant male circumcision in public hospitals are lifted without delay. And it is essential that the federal government revises the Medicare rebate so that this procedure is … affordable.”
ACON CEO Nicolas Parkhill told SX that with over 80 per cent of newly acquired HIV notifications in Australia arising from homosexual activity, he did not view circumcision as an essential HIV prevention priority in the Australian context, particularly as the current evidence had only shown that circumcision would be effective in contexts where there is a high risk of contracting HIV through female to male transmission.
“ACON does not support the implementation of male circumcision as a HIV prevention strategy in Australia.
“It’s likely that there would be a modest sex between men prevention benefit were all guys to be circumcised, but nowhere near at the level to justify a general reintroduction of the practice,” Parkhill said.
“A comprehensive health promotion approach including promoting consistent condom use is the safest and most cost effective HIV prevention strategy particularly with an epidemic which is concentrated amongst gay men and other men who have sex with men.”
Recent studies in the past decade involving heterosexual men in parts of Africa where there is a high prevalence of HIV infection have found that circumcision can offer significant population-level prevention benefits.
In 2007, the World Health Organisation and UNAIDS recommended that an expansion of male circumcision services be reserved for countries with “hyperendemic and generalized HIV epidemics and low prevalence of male circumcision”.